脑动静脉畸形合并出血相关危险因素分析

Bleeding in patients with cerebral arteriovenous malformation:an analysis of contributing factors

目的通过数字减影血管造影(DSA)检测脑动静脉畸形(AVM)血管构筑特征,探讨脑动静脉畸形合并出血的相关影响因素,以期预测脑AVM出血的危险性。方法采用DSA为87例脑AVM患者行全脑血管造影。采用SPSS18.0软件行单因素和多因素Logistics回顾分析,分析畸形血管团的大小、位置、供血动脉类型、引流静脉数目、引流静脉路径、有无合并动脉瘤、有无合并静脉瘤等因素与畸形血管团破裂出血的关系。结果单因素分析表明,造成畸形血管团破裂出血的因素包括AVM大小、位置,供应动脉类型,引流静脉支数与合并动脉瘤。多因素Logistics分析发现,畸形血管团破裂出血独立危险因素是引流静脉支数与合并动脉瘤。结论与脑AVM出血密切相关的危险因素是引流静脉的数目和合并动脉瘤。

Objective To study the risks of bleeding in patients with AVM by means of DSA analysis of cerebral angio- architecture. Methods Digital subtraction angiography （DSA） was conducted on 87 patients with AVM. The possible relationships between bleeding and factors such as the location and size of AVM masses, the type and site of supplying arteries, the number and pathway of venous drainage, the co-existing aneurysrns or venous tumors and their locations, were assessed using univariate analysis and binary logistic regression. Results Univariate analysis suggested that fac- tors that were positively correlated to hemorrhagic presentation included the site and size of AVM masses, the type and site of supplying arteries, the number of venous drainages, and co-existing aneurysms. Step-wise multiple logistic re- gression analysis revealed that only the number of venous drainage and co-existing aneurysms were independent predic- tors for hemorrhagic presentation. Conclusion The number of venous drainages and co-existing anettrysms are risk predictors for hemorrhagic AVM presentation.